Download - Elissa O'Keefe - Bravura Education
Elissa O’Keefe RN NP FFACNP MACN
Interim Chair, Cosmetic Nursing Community of Interest
Australian College of Nursing
Future proof: Clinical governance
and education best practice for
cosmetic nursing
Outline
Context of practice
Scope of practice
NMBA position on cosmetic nursing
MBA guidelines
ARPANSA laser guidelines
Cosmetic nursing as a specialty
Standards and scope of practice for cosmetic nursing
Post graduate education
CPD
ACN Cosmetic Nursing Community of Interest
Cosmetic nursing contexts of practice
In collaboration with medical
colleagues such as with
cosmetic physicians, plastic
surgeons or dermatologists
Private or public healthcare
settings
Nurse-led clinics
Independently* in private
practice
Scope of practice
Determined by the individual’s:
– Education
– Training
– Competence
– Authorisation in the practice setting by the employer’s organisational policies and requirements
– The ultimate boundaries of scope of practice are the nurse’s confidence in their own professional capability, legislation and regulation
NMBA position on nurses providing
cosmetic procedures
MBA guidelines on cosmetic
medical and surgical procedures
ARPANSA guidelines (laser safety)
National uniformity for:
1. Minimum education (likely to include an accredited laser/IPL
safety certificate)
2. Training
3. Terminology
4. Equipment
5. Patient care and
6. Injury reporting.
Recognition as a specialty?
NMBA
Organisations representing speciality nursing
groups in Australia have developed processes for
recognising speciality practice.
This provides a sufficient means of acknowledging
specialist nursing practice in Australia, and may be
recognised by employers and the health industry at
large.
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/FAQ/fact-sheet-advanced-nursing-practice-
and-specialty-areas.aspx
International exposure
Standards and scope of practice
For an electronic copy: www.bravuraeducation.com/pages/contact
Principles of professional practice
1. Nurses are registered with the Australian Health Practitioner Regulation Agency (AHPRA)
2. Nurses should work within their scope of practice based on each nurse’s education, knowledge, competency, extent of experience and lawful authority
3. Clinical care is governed by evidence-based standard operating policy and procedures/ clinical practice guidelines or similar
4. Clients/patient presentations that fall outside the scope of practice of the nurse are referred to an appropriate, competent person
5. Participate in decision making to ensure that nurses are able to deliver the best patient outcomes.
Principles of clinical practice
1. Adhere to health practitioner
regulation
2. Unregistered practitioners
3. Work with safety and quality
frameworks
4. Maintain client/patient
confidentiality and privacy
5. Obtain informed consent
6. Maintain health records,
considering information privacy
and access
http://www.centerforhealthjournalism.org/files/title_images/transporting_medical_rec
ords_849x565_1.jpg
Principles of clinical practice (cont’d)
7. Administer medicines safely and
effectively
8. Utilise medical devices safely and
effectively
9. Maintain the principles of infection
control
10. Obtain informed financial consent
11. Utilise technology-based patient
consultations safely and effectively
12. Provide objective advice and dispense
cosmeceuticals/medical grade skin care
13. Introduce new technologies or
treatments based on best patient
outcomes and evidence
Domains of practice
Domain 1: Assess client,
plan and deliver
appropriate care
Domain 2: Administers
botulinum toxin A safely
and effectively
Domain 3: Administers
filler and related products
safely and effectively
Domain 4: Delivers laser,
intense pulsed light and
related therapies safely
and effectively
Activities of practice
1. Client care
2. Medication administration
3. Treatments
Client care
Wound care
Acne management
Scarring
Rosacea
Anti-ageing/skin fitness
Skin sensitivity
Sun damage
Pigmentation
Leg and facial capillaries
Removal of unwanted hair
Removal of benign skin lesions
Skin tightening
Fat reduction
Referral to a specialist.
Medication (EEN, RN, NP)
Dermal fillers
Muscle/wrinkle relaxants
? Deoxycholic acid (Belkyra)
Other scheduled medicines as required (e.g. topical anaesthetic)
Prescribing medication (NP).
EEN S4 administration under direct supervision of an RN
RN administer S4 medication
NP authorised to obtain, possess, supply, administer, prescribe and dispense medications
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Treatments
Intense pulsed light
Laser (including but not limited to Thulium/Erbium, Nd:YAG, Ruby, Alexandrite)
Microdermabrasion
Chemical peels (AHA, BHA, Jessner, TCA, Retinoid)
Light Emitting Diode (LED) therapy
Radiofrequency therapy
Ultrasound therapy
Dermal rollering/needling
Platelet rich plasma
Photodynamic therapy
Cosmetic tattooing
Tattoo removal
Sclerotherapy
Lipodissolve
Fat reduction
Benefits of having a framework
It sets the standard for what would be expected of nurses in an aesthetic context
It enables career pathway development
It can be used as an audit tool for both individual clinicians and supervisors and /or employers to identify strengths, areas for development and to plan professional development
Where it has been used as an audit tool it can be used as evidence of continuing professional development
It can be used as a basis for role development, job descriptions and performance evaluation.
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Examples of post graduate education
Accredited Laser/IPL Safety
Certificate
Continuing professional
development modules
Diploma in Cosmetic Nursing
Graduate Diploma in Cosmetic
Nursing
Community and Primary Health
Nursing
Master of Clinical Nursing
Master of Nurse Practitioner
(Primary Health Care pathway)
Industry
CPD requirements
20 hours per year
Nurse practitioners must complete at least 10 hours per
year in education related to their endorsement
One hour of active learning will equal one hour of CPD. It
is the nurse’s responsibility to calculate how many hours
of active learning have taken place
CPD must be relevant to the nurse’s context of practice
Nurses must keep written documentation of CPD
Participation in mandatory skills acquisition may be
counted as CPD.
CPD requirements (cont’d)
CPD must demonstrate that the nurse has:
– identified and prioritised their learning needs,
based on an evaluation of their practice against
the relevant competency or professional practice
standards
– developed a learning plan based on identified
learning needs
– participated in effective learning activities relevant
to their learning needs
– reflected on the value of the learning activities or
the effect that participation will have on their
practice.
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Documenting CPD
• Date
• Source or provider details
• Identified learning needs
• Action plan
• Type of activity
• Description of topic/s covered during
activity and outcome
• Reflection on activity and specification
to practice
• No./Title /Description of evidence
provided
• CPD hours
• A template for this can be found on the
NMB website.
Networks
Future opportunities for cosmetic nursing
1. Research, research, research…
2. A consistent communication platform
3. Continual development of accredited
education initiatives that demonstrate a valid
career pathway and articulate into a suite of
post graduate knowledge and skills
4. Rejuvenation of professional practice
standards and scope of practice
5. Sharing of industry trends, changes in clinical
practice etc.
6. Lobbying of government to ensure that
nurses continue to be enabled to deliver
excellent patient outcomes
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COSMETIC NURSING
COMMUNITY OF INTEREST
Cosmetic Nursing Community
of Interest